Female sexual dysfunction is common among women with diabetes and is influenced by multiple psychological and metabolic factors. A network meta-analysis published in the Journal of Diabetes & Metabolic Disorders evaluated the comparative effectiveness of psychological intervention models for improving sexual function in women with diabetes.

The analysis included randomized controlled trials and quasi-experimental studies published between 2015 and 2025 that evaluated PRECEDE, PLISSIT, BETTER, or structured counseling interventions. Sexual function outcomes were assessed using the Female Sexual Function Index (FSFI) or comparable validated measures. A frequentist random-effects network meta-analysis using standardized mean differences (SMDs) was performed.

Findings

• The analysis included 10 studies involving 1,294 women with diabetes, including 3 randomized controlled trials and 7 quasi-experimental studies.
• All intervention models showed positive effect sizes compared with control groups.
• PRECEDE demonstrated the highest point estimate (SMD 2.14; 95% confidence interval [CI] −0.02 to 4.30), followed by BETTER (SMD 1.38; 95% CI −0.38 to 3.15), counseling (SMD 0.92; 95% CI −0.05 to 1.89), and PLISSIT (SMD 0.73; 95% CI −0.59 to 2.05).
• Confidence intervals for all interventions overlapped and included null values, indicating no statistically significant differences versus control.
• Substantial heterogeneity was observed across studies (I² = 97.7%), while quasi-experimental studies showed larger effect estimates than randomized controlled trials.
• Most included studies showed high risk of bias, particularly in blinding and performance domains.

Psychological interventions may improve female sexual dysfunction in women with diabetes. However, comparative effectiveness remains uncertain because available evidence was indirect and highly heterogeneous. Current findings do not establish superiority of any single intervention model.